Individual
MS. COLLEEN LEVEILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2500 E PROSPECT RD, FORT COLLINS, CO 80525-9718
(970) 493-0112
Mailing address
2500 E PROSPECT RD, FORT COLLINS, CO 80525-9718
(970) 493-0112
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10589
GA
363A00000X
Physician Assistant
Primary
PA.0008738
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15376108
CAQH
—
Enumeration date
08/16/2021
Last updated
09/16/2024
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